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Published on: 1/29/2026

Chronic diarrhea that won’t go away

Chronic diarrhea means loose or frequent stools lasting 4 weeks or more or recurring over months, and it can result from IBS, IBD, microscopic colitis, lingering infections, food intolerances like lactose or celiac disease, medications, malabsorption, or hormonal issues. There are several factors to consider; see below for red flags that need urgent care such as blood, weight loss, nighttime diarrhea, fever, severe pain, or dehydration. Evaluation and treatment vary by cause and may include history, blood and stool tests, breath tests or endoscopy, plus practical steps like hydration, diet adjustments, stress management, and medication changes under medical guidance, with full details and next-step guidance outlined below.

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Explanation

Chronic Diarrhea That Won't Go Away: What You Need to Know

Diarrhea is common, but when it lasts for weeks or keeps coming back, it deserves careful attention. Chronic diarrhea is usually defined as loose, watery, or frequent stools that continue for four weeks or longer. While it's often manageable, persistent diarrhea can affect daily life, hydration, nutrition, and overall health. This guide explains possible causes, what to watch for, how doctors evaluate it, and practical steps you can take—using clear, common language and trusted medical understanding.


What Counts as Chronic Diarrhea?

Diarrhea becomes "chronic" when it:

  • Lasts 4 weeks or more, or
  • Comes and goes but keeps returning over months

People may notice:

  • Loose or watery stools
  • Urgency (needing to go right away)
  • Increased frequency (more than 3 times a day)
  • Bloating, cramping, or gas
  • Fatigue or dehydration

Not all chronic diarrhea is severe, but it should not be ignored.


Common Causes of Chronic Diarrhea

There isn't one single cause. Doctors usually group causes into a few broad categories.

1. Digestive Conditions

These affect how the gut functions or absorbs nutrients.

  • Irritable Bowel Syndrome (IBS-D)
    A common condition where the gut is sensitive. Diarrhea may alternate with normal stools, often linked to stress or certain foods.
  • Inflammatory Bowel Disease (IBD)
    Includes Crohn's disease and ulcerative colitis. These involve ongoing inflammation and need medical care.
  • Microscopic colitis
    Often causes watery diarrhea, especially in older adults, and can be missed without specific testing.

2. Infections That Linger

Some infections don't clear easily or trigger long-term gut changes.

  • Certain bacterial or parasitic infections
  • Post-infectious diarrhea, where symptoms continue after the infection is gone

3. Food-Related Causes

Your body may not tolerate certain foods well.

  • Lactose intolerance (trouble digesting milk sugar)
  • Gluten sensitivity or celiac disease
  • Sensitivity to artificial sweeteners (like sorbitol)
  • High intake of caffeine or alcohol

4. Medication Side Effects

Many commonly used medicines can cause ongoing diarrhea.

  • Antibiotics
  • Metformin (for diabetes)
  • Some antidepressants
  • Magnesium-containing supplements or antacids

Never stop a prescribed medication without speaking to a doctor.

5. Hormonal or Metabolic Issues

Less common, but important to consider.

  • Overactive thyroid (hyperthyroidism)
  • Diabetes-related nerve changes
  • Certain rare hormone-secreting tumors

6. Malabsorption Problems

When the body can't absorb nutrients properly.

  • Pancreatic enzyme insufficiency
  • Bile acid malabsorption
  • Short bowel or prior intestinal surgery

When Chronic Diarrhea Needs Urgent Attention

While many causes are manageable, some symptoms should be taken seriously. Speak to a doctor promptly if diarrhea is accompanied by:

  • Blood or black, tarry stools
  • Unexplained weight loss
  • Ongoing fever
  • Nighttime diarrhea that wakes you up
  • Severe abdominal pain
  • Signs of dehydration (very dark urine, dizziness, dry mouth)
  • Diarrhea in infants, older adults, or during pregnancy

These signs don't always mean something dangerous—but they do require medical evaluation.


How Doctors Evaluate Chronic Diarrhea

A careful evaluation helps narrow down the cause. A doctor may:

  • Ask detailed questions about:
    • Stool appearance and frequency
    • Diet, travel, and stress
    • Medications and supplements
    • Family history of gut disease
  • Order tests such as:
    • Blood tests (to check inflammation, thyroid function, anemia)
    • Stool tests (for infection, blood, or inflammation)
    • Breath tests (for lactose intolerance)
    • Imaging or endoscopy, if needed

The goal is to find the cause and tailor treatment—rather than guessing.


Practical Steps You Can Take Now

While waiting to see a doctor, these steps may help reduce symptoms and protect your health.

Support Hydration

Chronic diarrhea increases fluid loss.

  • Drink water regularly
  • Consider oral rehydration solutions if stools are very loose
  • Limit alcohol and high-sugar drinks

Adjust Your Diet Thoughtfully

Simple changes can make a difference.

  • Eat smaller, more frequent meals
  • Try bland foods (rice, bananas, toast)
  • Temporarily reduce:
    • Dairy
    • Fatty or spicy foods
    • Artificial sweeteners
  • Keep a food and symptom diary to spot triggers

Review Medications

  • Check if diarrhea started after a new medication
  • Discuss alternatives with your doctor if needed

Manage Stress

The gut and brain are closely connected.

  • Gentle exercise
  • Adequate sleep
  • Relaxation techniques (deep breathing, mindfulness)

The Role of Symptom Checking

If you're experiencing persistent symptoms and want to better understand what might be causing them, using a free AI-powered diarrhea symptom checker can help you organize your concerns and identify possible causes before speaking with your doctor. Tools like this can help you prepare for a more focused conversation with a healthcare provider. They are not a diagnosis, but they can be a helpful starting point.


Treatment Depends on the Cause

There is no one-size-fits-all treatment for chronic diarrhea. Options may include:

  • Dietary changes or elimination diets
  • Medications to slow bowel movement
  • Treating infections or inflammation
  • Enzyme or bile acid replacement
  • Adjusting or changing current medications

Many people improve significantly once the underlying cause is identified.


Why You Should Speak to a Doctor

Chronic diarrhea is not something you need to "just live with." While it is often treatable, some causes can be serious if left unchecked. Speaking to a doctor ensures:

  • Proper diagnosis
  • Safe and effective treatment
  • Monitoring for complications like dehydration or nutrient deficiencies

If symptoms are severe, worsening, or include warning signs, seek medical care promptly.


Key Takeaways

  • Diarrhea that lasts more than four weeks is considered chronic and should be evaluated.
  • Common causes include digestive conditions, food intolerances, medications, and infections.
  • Red flag symptoms require prompt medical attention.
  • Simple steps—hydration, diet adjustments, and stress management—can help.
  • Consider a free online symptom check to organize your concerns.
  • Always speak to a doctor about persistent, serious, or life‑threatening symptoms.

Chronic diarrhea can be frustrating, but with the right approach and medical guidance, most people find answers and relief.

(References)

  • * Choi CH, Kim YS. Chronic Diarrhea in Adults: A Diagnostic Approach. Gut Liver. 2018 Sep;12(5):502-511. doi: 10.5009/gnl17482. PMID: 29874676; PMCID: PMC6116812.

  • * Rubenstein JH, Riddle MS, Shiau C, Chey WD; American College of Gastroenterology. Chronic Diarrhea: Diagnosis and Treatment. Am J Gastroenterol. 2016 Oct;111(10):1378-1406. doi: 10.1038/ajg.2016.353. PMID: 27729623.

  • * Jafar S, Ahmad S, Aziz K, Khoshhal S. Evidence-based approach to chronic diarrhoea. J R Coll Physicians Edinb. 2019 Jun;49(2):107-113. doi: 10.4997/JRCPE.2019.206. PMID: 31215286.

  • * Farhat S, Maqsood F, Niaz SK, Nisar A. Unexplained chronic diarrhea: An approach to diagnosis and management. JGH Open. 2021 May 26;5(6):663-671. doi: 10.1002/jgh3.12519. PMID: 34109315; PMCID: PMC8174542.

  • * Kunkel D, Pimentel M, Shah N, Chey WD. Chronic Diarrhea: Diagnostic and Management Approach. Clin Gastroenterol Hepatol. 2023 Mar;21(3):421-432. doi: 10.1016/j.cgh.2022.12.008. PMID: 36566085.

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